Effect of a constant rate infusion of cytosine arabinoside on mortality in dogs with meningoencephalitis of unknown origin

Lowrie, Mark; Thomson, Sarah; Smith, Peter M.; Garosi, Laurent

doi:10.1016/j.tvjl.2016.03.026

Cited by 36 publications

(61 citation statements)

References 19 publications

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“…Later, dogs (n=6) received CA as a constant rate of intravenous infusion during eight hours with a dosage of 25 mg/m 2 /hour, based upon a modification of the protocol by Lowrie et al . 24 In the present investigation, the treatment protocol was shortened to three administrations every three weeks, followed by three administrations every four weeks. Afterwards three administrations every five weeks and finally three administrations every six weeks were applied.…”

Section: Resultsmentioning

confidence: 99%

Evaluating the use of cytosine arabinoside for treatment for recurrent canine steroid‐responsive meningitis‐arteritis

et al. 2020

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BackgroundRelapses in steroid-responsive meningitis-arteritis (SRMA) are frequently observed but specific treatment protocols to address this problem are sparsely reported. Standard treatment includes prolonged administration of glucocorticoids as monotherapy or in combination with immunosuppressive drugs. The aim of this study was to assess the safety and efficacy of cytosine arabinoside (CA) in combination with glucocorticoids for treatment of SRMA relapses in 12 dogs on a retrospective basis.MethodsDogs with recurrent episodes of SRMA and treated with a combination of CA and prednisolone were included. Information about clinical course, treatment response and adverse events was collected from medical records. Ethical approval was not required for this study.ResultsTen dogs (10/12) responded well to the treatment with clinical signs being completely controlled. One dog is in clinical remission, but still under treatment. One dog (8%) showed further relapse. Mean treatment period was 51 weeks. Adverse events of variable severity (grade 1–4/5) were documented in all dogs during treatment according to the veterinary cooperative oncology group grading. Three dogs developed severe adverse events. Laboratory findings showed marked changes up to grade 4. Diarrhoea and anaemia were the most often observed adverse events (6), followed by dermatitis (4), alopecia (3) and pneumonia (3). Including blood chemistry changes (13), 50 adverse events were found in total.ConclusionTreatment with CA and glucocorticoids resulted in clinical remission in 10/12 dogs, but a high incidence of adverse events occurred requiring additional measures. All adverse events could be managed successfully in all cases.

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Section: Resultsmentioning

confidence: 99%

Evaluating the use of cytosine arabinoside for treatment for recurrent canine steroid‐responsive meningitis‐arteritis

et al. 2020

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“…In previously published studies, the combination of prednisolone with cytosine arabinoside improved survival times in dogs with MUO. In this study, the majority of dogs were also treated with cytosine arabinoside and prednisolone.…”

Section: Discussionmentioning

confidence: 83%

Postencephalitic epilepsy in dogs with meningoencephalitis of unknown origin: Clinical features, risk factors, and long‐term outcome

Kaczmarska

José-López

Czopowicz

et al. 2020

Veterinary Internal Medicne

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Background Although the presence of seizures in dogs with meningoencephalitis of unknown origin (MUO) has been associated with shorter survival times, data regarding the prevalence and risk factors for postencephalitic epilepsy (PEE) is lacking. Objectives To describe the clinical features, prevalence, risk factors, and long‐term outcome of PEE in dogs with MUO. Animals Sixty‐one dogs with presumptive diagnosis of MUO based on the clinicopathological and diagnostic imaging findings. Methods Retrospective study. Cases were identified by search of hospital medical records for dogs with suspected or confirmed MUO. Medical records of dogs meeting inclusion criteria were reviewed. Signalment, seizure history, clinicopathologic, and magnetic resonance imaging (MRI) findings were recorded. Results Among 61 dogs at risk of PEE, 14 (23%) dogs developed PEE. Three of 14 dogs with PEE (21%) developed drug‐resistant epilepsy. Dogs with PEE were younger (P = .03; ORadjusted = 0.75; 95% confidence interval [CI], 0.58‐0.98) and had significantly shorter survival times (log‐rank test P = .04) when compared to dogs that did not develop epilepsy. The risk factors associated with the development of PEE were the presence of acute symptomatic seizures (ASS; P = .04; ORadjusted = 4.76; 95% CI, 1.11‐20.4) and MRI lesions in the hippocampus (P = .04; ORadjusted = 4.75; 95% CI, 1.07‐21.0). Conclusions and Clinical Importance Dogs with MUO and seizures at the early stage of the disease (ASS) seem to be at a higher risk of developing PEE.

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“…Of the five studies receiving CA, three received SC CA (not including Lowrie et al, (2016) historical control group), one a single IV dose of CA, and one IV CA followed by SC CA. Lowrie et al (2016) found significantly better survival with dogs receiving their first dose of CA by CRI followed by SC compared with dogs receiving only SC CA. Smith et al (2009) also noted an increase in estimated mean survival when compared with other studies (median survival estimate 1063 days).…”

Section: Veterinarymentioning

confidence: 87%

“…Smith et al (2009) also noted an increase in estimated mean survival when compared with other studies (median survival estimate 1063 days). Almost all dogs treated with CA and prednisolone surviving to 3 months went on to survive to 12 months (Lowrie et al, 2016;Lowrie et al, 2013;Smith et al, 2009). It is not possible to directly compare CA with prednisolone to prednisolone as a sole therapy for treatment of MUO from the available literature.…”

Section: Veterinarymentioning

confidence: 99%

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2018

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Clinical scenario You are presented with a 4-year-old male neutered Boston Terrier with a five day history of seizures, progressive mentation changes and compulsive circling. The patient has had no previous ailments or been on any previous treatments. Multifocal intensities were noted within the forebrain on MRI (T2-weighted). Mixed mononuclear pleocytosis with increased protein concentration was noted on cerebrospinal fluid (CSF) examination. Negative serology and CSF titres for Neospora caninum and Toxoplasma gondii were performed. A provisional diagnosis of MUO is made for which you want to start treatment soonest, but you are unsure of the effectiveness of using a combination of cytosine arabinoside with prednisolone compared with prednisolone alone. The evidence There is limited available evidence for treating MUO involving CA in combination therapy with prednisolone or prednisolone alone. Five studies were located examining the effect of CA in combination with prednisolone, with a relatively small number of cases reported in each of these. Only one paper was identified studying the use of prednisolone alone for treatment of MUO. The available evidence is weak as five studies were case series, with high likelihood of bias, the inability to detect much of the bias, and the inability to estimate a treatment effect. A repeat literature search involving different chemotherapeutic treatment options for MUO could be beneficial. Whilst there is no direct comparison between these two treatment options, CA with prednisolone had greater actual and estimated median survival time than prednisolone as a sole therapy in dogs with MUO.

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Effect of a constant rate infusion of cytosine arabinoside on mortality in dogs with meningoencephalitis of unknown origin

Cited by 36 publications

References 19 publications

Evaluating the use of cytosine arabinoside for treatment for recurrent canine steroid‐responsive meningitis‐arteritis

Evaluating the use of cytosine arabinoside for treatment for recurrent canine steroid‐responsive meningitis‐arteritis

Postencephalitic epilepsy in dogs with meningoencephalitis of unknown origin: Clinical features, risk factors, and long‐term outcome

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